The cost of Surgeon vs Anesthetist

[SueInBoston]

Hope your recovery is going well...

 

[abdmom]

This brings back awful memories of my emergency C section in a little rural hospital. Saturday night. The anesthesiologist had gone home. As they're slathering betadine on my belly, a couple of random people are trying to insert IV's in my arms. Then they slap a mask on me and hold it down. Only problem is, there's no gas coming through the mask, so they're suffocating me! I pull of the mask and say "No gas, no gas" 'cause i'm in labour and having a hard time breathing, right? They slap that mask right back on and say "you need the gas" and proceed to suffocate me once again. The next time I manage to get the mask off, I manage to say "There is no gas". Luckily, that was before the surgeon started cutting. I'm hyperventilating just thinking about it.

 

[LSmith]

This brings back awful memories of my emergency C section in a little rural hospital. Saturday night. The anesthesiologist had gone home. As they're slathering betadine on my belly, a couple of random people are trying to insert IV's in my arms. Then they slap a mask on me and hold it down. Only problem is, there's no gas coming through the mask, so they're suffocating me! I pull of the mask and say "No gas, no gas" 'cause i'm in labour and having a hard time breathing, right? They slap that mask right back on and say "you need the gas" and proceed to suffocate me once again. The next time I manage to get the mask off, I manage to say "There is no gas". Luckily, that was before the surgeon started cutting. I'm hyperventilating just thinking about it.

This is just beyond gross and nightmarish!

 

[minkydog]

If you really think about what they do it will send shivers up your spine.

They have to do 2 things:

1) Make sure you are paralyzed

2) Make sure you can't feel the pain.

I imagine the worst thing that could happen is succeeding at #1 and failing at #2.

And number three is make sure you wake up at the end! Yeah, give me a good anesthesiologist any day

 

[johnsontrio]

If you really think about what they do it will send shivers up your spine.

They have to do 2 things:

1) Make sure you are paralyzed

2) Make sure you can't feel the pain.

I iehtemagine the worst thing that could happen is succeeding at #1 and failing at #2.

It's a common misconception that the surgeon is top of the food chain when you go in for surgery. They are responsible for their procedure, but the anesthesia provider is the "Captain of the Ship". Any injury that results to the patient while in the OR falls directly to the anesthesia provider. They are the ones 100% responsible for injury to the patient, no matter the source, such as, OR fires, injury from positioning (such as nerve palsy), burns to the patient from bovie or other equipment, accidental injury from the surgery team (such as hitting the pt's face, etc while it is behind the drapes). We of course, pick our surgeons carefully, but the anesthesia provider is the one that makes sure you get out of the room without injury. The anesthesia provider takes the patient in the room and is with them from beginning to end. The surgeon often comes in only once the patient is prepped and draped and leaves once they are closed. The patient still has to be emerged from anesthesia. The anesthesia provider is the only one watching vital signs, oxygenation, blood counts, CO2 monitoring etc...

When patients comment on the cost of being put to sleep, we tell them "oh, they don't charge to put you to sleep, they only charge to wake you up!"

 

[ols386]

This brings back awful memories of my emergency C section in a little rural hospital. Saturday night. The anesthesiologist had gone home. As they're slathering betadine on my belly, a couple of random people are trying to insert IV's in my arms. Then they slap a mask on me and hold it down. Only problem is, there's no gas coming through the mask, so they're suffocating me! I pull of the mask and say "No gas, no gas" 'cause i'm in labour and having a hard time breathing, right? They slap that mask right back on and say "you need the gas" and proceed to suffocate me once again. The next time I manage to get the mask off, I manage to say "There is no gas". Luckily, that was before the surgeon started cutting. I'm hyperventilating just thinking about it.

That is absolutely horrifying. Very scary.

 

[indygirl99]

The anesthesia provider is the only one watching vital signs, oxygenation, blood counts, CO2 monitoring etc...

I pretty sure there are a few nurses who would take objection to this statement me among them.

 

[firecracker725]

During both of my csections it has been the anesthesiologist who talked to me and told me things that were going on. I love my OB, but the anesthesiologist was the guy.

 

[HugsForEeyore]

I had surgery recently and the cancer surgeon (it was benign thank God!) was $1850 and the anesthesiologist was $2700. But these were just the doctor's individual fees. The hospital's bill also charged another $5500 for anesthesia services and the surgeon had another $5000+ on there as well. My insurance paid very little so I remember all the charges quite well. But I remember also being surprised that the anesthesiologist was more than a cancer surgeon!

 

[Tiggeroo]

What bothers me about anesthesiologist a is that often insurance doesn't cover their bill the same. Recently had minor surgery. Insurance company said they are never in network and I have to hope they agree to acceptable and customary amount. Also sad what insurance pays versus what uninsuredight pay. For a 1400. Procedure my insurance paid in believe 500. And dr accepts it.

 

[HugsForEeyore]

What bothers me about anesthesiologist a is that often insurance doesn't cover their bill the same. Recently had minor surgery. Insurance company said they are never in network and I have to hope they agree to acceptable and customary amount. Also sad what insurance pays versus what uninsuredight pay. For a 1400. Procedure my insurance paid in believe 500. And dr accepts it.

That's what happened to me. My crappy insurance covered nothing of the anesthesiologist and no one would "work with me" - I had to pay 100% of the $2700 out of pocket. Even worse, when my "catastrophic" (aka worthless) insurance denied the bill, it was sent straight to a collection agency - I was never even given a chance to pay it outright or negotiate. With this bill and all the other medical bills, I pretty much lost all of my savings and most of my retirement in one day because of having surgery with no insurance. Get too depressed if I think about it too much.

 

[WendyWuWu]

I am an anesthetist. While I do know some surgeons (cardiothoracic surgeons during open heart bypass surgeries or vascular surgeons during extensive bypass surgeries) who watch the vital signs during a case, most do not. Keeping a patient stable, paralyzed, anesthetized, and pain free is the responsibility of the anesthesia provider almost solely. It is the anesthetist's responsibility to monitor blood loss and replacement, urine output, vital signs, paralysis and analgesia. I, too, when in need of surgery, worry much more about my anesthesia than the skill of the surgeon. I can not tell you how many times I've seen a patient clasp a surgeon's hand and say "take good care of me" or "make sure I wake up/live" or "save me, doc!", but in reality, (unfortunately perhaps), the surgeon is not the only one to make sure someone survives surgery. It's the anesthesia provider, be in an anesthesiologist or nurse anesthetist (CRNA), who keeps a watchful eye on EVERYTHING while you're asleep.

 

[dustpixie]

Also sad what insurance pays versus what uninsuredight pay. For a 1400. Procedure my insurance paid in believe 500. And dr accepts it.

I broke my arm in a fall last October. The emergency room billed $12,500 for three hours in a room, an x-ray, ct scan, a sling, and a referral to an orthopedist. Insurance got discounts and paid $4,000. What exactly makes an uninsured person cost $8,500 more to treat?!!

 

[LisaR]

I am an anesthetist. While I do know some surgeons (cardiothoracic surgeons during open heart bypass surgeries or vascular surgeons during extensive bypass surgeries) who watch the vital signs during a case, most do not. Keeping a patient stable, paralyzed, anesthetized, and pain free is the responsibility of the anesthesia provider almost solely. It is the anesthetist's responsibility to monitor blood loss and replacement, urine output, vital signs, paralysis and analgesia. I, too, when in need of surgery, worry much more about my anesthesia than the skill of the surgeon. I can not tell you how many times I've seen a patient clasp a surgeon's hand and say "take good care of me" or "make sure I wake up/live" or "save me, doc!", but in reality, (unfortunately perhaps), the surgeon is not the only one to make sure someone survives surgery. It's the anesthesia provider, be in an anesthesiologist or nurse anesthetist (CRNA), who keeps a watchful eye on EVERYTHING while you're asleep.

Well said!

It is frightening that the patient gets to pick our surgeon, but we don't get to pick our anesthesiologist.


DH had surgery in October. The anesthesiologist came by before he was taken back and asked all kinds of questions, went over his allergies, discussed our concerns, and went over what he would be doing. Just as they are about to take DH back, a new anesthesiologist comes walking up and says he is taking over because the other guy went to lunch. Okay?? I get they have to eat, but they didn't know their schedule in advance? The new guy said the other guy filled him in on everything. I wasn't thrilled, but what were my options? It didn't help when the new guy discovered DH was allergic to Tylenol and the anesthesiologist said he didn't remember the other guy telling him that.

 

[Imhere]

ZOMBIE THREAD!!!!!

But really, who cares how well the surgery went if you don't wake up after.

 

[LisaR]

ZOMBIE THREAD!!!!!

But really, who cares how well the surgery went if you don't wake up after.

Oh my! I didn't realize the date of this thread. I've never understood why people bring back threads for no apparent reason.

 

[Soldier's*Sweeties]

I am an anesthetist. While I do know some surgeons (cardiothoracic surgeons during open heart bypass surgeries or vascular surgeons during extensive bypass surgeries) who watch the vital signs during a case, most do not. Keeping a patient stable, paralyzed, anesthetized, and pain free is the responsibility of the anesthesia provider almost solely. It is the anesthetist's responsibility to monitor blood loss and replacement, urine output, vital signs, paralysis and analgesia. I, too, when in need of surgery, worry much more about my anesthesia than the skill of the surgeon. I can not tell you how many times I've seen a patient clasp a surgeon's hand and say "take good care of me" or "make sure I wake up/live" or "save me, doc!", but in reality, (unfortunately perhaps), the surgeon is not the only one to make sure someone survives surgery. It's the anesthesia provider, be in an anesthesiologist or nurse anesthetist (CRNA), who keeps a watchful eye on EVERYTHING while you're asleep.

Well *I* appreciate people like you!

I had the best one when I had a surgery(3 hours long) two years ago. He came in and greeted me WITH my surgeon. I said I was terrified of going under. I was so scared I had a panic attack in front of him!

He talked me down and when it was time to go under I didn't even know what was happening! I was wheeled in and he asked how I was doing and reassured me. I thought he was just messing with my IV tubes then BAM...The room closed in around me. I really appreciated the fact that he didn't tell me what was happening or the whole countdown thing. No time for me to panic again.

 

[Lita]

I broke my arm in a fall last October. The emergency room billed $12,500 for three hours in a room, an x-ray, ct scan, a sling, and a referral to an orthopedist. Insurance got discounts and paid $4,000. What exactly makes an uninsured person cost $8,500 more to treat?!!

Hospitals have contracts where they negotiate fees for services with the various insurance companies, thus the basis for the discounts. Most hospital systems have self-pay programs where they charge a patient the average reimbursement that they would receive from an insurance carrier. This along with the charity programs that hospitals have, it is rate the an uninsured patient will be asked to pay full charges for services.

Sent from my iPad using DISBoards

 

[Gracie09]

I broke my arm in a fall last October. The emergency room billed $12,500 for three hours in a room, an x-ray, ct scan, a sling, and a referral to an orthopedist. Insurance got discounts and paid $4,000. What exactly makes an uninsured person cost $8,500 more to treat?!!

That some of them will walk away from the bill and the hospital has to pay it's bills. That insurance companies negotiate rates that are below cost and the hospital has to pay it's bills.

 

[lauradis]

ZOMBIE THREAD!!!!!

But really, who cares how well the surgery went if you don't wake up after.

We love ZOMBIES... Brains